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General NPI Number Information
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NPI Number | 1467596742
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Entity Type | Individual
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Provider Name | SILVA TAVITIAN D.C.
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Gender | Female
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3993 LAVISTA RD
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City | TUCKER
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State | GA
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Zip | 30084-5139
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Country | US
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Telephone | 770-270-1119
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Fax |
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Provider Business Mailing Address
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Address Line | 5386 HAVERFORD MILL CV
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City | LILBURN
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State | GA
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Zip | 30047-5974
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Country | US
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Telephone | 770-923-6967
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | CHIRO08901
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License Number State | GA
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